COVID-19 Pandemic and Telemental Health (TMH) Policy Reforms

Abstract

Many patients with mental disorders lack access to care mainly due to provider shortages. Telemental Health (TMH) is a growing field that expands access to care, eases stigma, and can act as a cost-effective alternative to the costly conventional mental health care. However, there are barriers to the adoption of TMH including technical issues, licensure and prerequisites, and financial and reimbursement challenges.

During the COVID-19 pandemic, some policies and regulations changed to address the increase in demand for TMH services. For instance, the federal government increased funding for the new telehealth initiatives and 26 states legalized the interstate practice for psychologists. Also, Medicare removed restrictions on the location of encounters, waived telehealth co-payments, reimbursed audio-only visits, and required payment parities between virtual and in-person visits. Despite these changes to increase access to care, Medicare maintained in-person visit prerequisite within the six months prior to the first time only for mental health treatments which can act as a hindrance. Policy changes during the pandemic increased TMH adoption and approximately 78% of mental health providers integrated TMH services into their practice. Nevertheless, it is unclear whether these policy changes will remain in place after the pandemic is over. The beneficiary regulatory changes should be sustained, and policymakers need to collect more data to decide whether and how to keep these changes permanently for TMH.